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Pretreatment metabolic tumour volume is predictive of disease-free survival and overall survival in patients with oesophageal squamous cell carcinoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

It has been suggested that FDG PET has predictive value for the prognosis of treated oesophageal carcinoma. However, the studies reported in the literature have shown discordant results. The aim of this study was to determine whether pretherapy quantitative metabolic parameters correlate with patient outcomes.

Methods

Included in the study were 67 patients with a histological diagnosis of oesophageal squamous cell carcinoma. Each patient underwent 18F-FDG PET (4.5 MBq/kg) before chemoradiotherapy. Quantitative analysis was performed using the following parameters: age, weight loss, location, N stage, OMS performance status, MTVp and MTVp′ (metabolic tumour volume determined by two different physicians), MTV40% (volume for a threshold of 40 % of SUVmax), MTVa (volume automatically determined with a contrast-based adaptive threshold method), SUVmax, SUVmean and TLG (total lesion glycolysis).

Results

MTVp and MTV40% were highly correlated (Pearson’s index 0.92). SUVmeanp and SUVmean40% were also correlated (Pearson’s index 0.86), as were TLGp and TLG40% (Pearson’s index 0.98). Similarly, the parameters obtained with the adaptive threshold method (MTVa, SUVmeana and TLGa) were correlated with those obtained manually (MTVp, SUVmeanp and TLGp). The manual metabolic tumour volume determination (MTVp and MTVp′) was reproducible. Multivariate analysis for disease-free survival (DFS) showed that a larger MTVp was associated with a shorter DFS (p = 0.004) and that a higher SUVmax was associated with a longer DFS (p = 0.02). Multivariate analysis for overall survival (OS) showed that a larger MTVp was associated with a shorter OS (p = 0.01) and that a tumour in the distal oesophagus was associated with a longer OS (p = 0.005). The associations among the other parameters were not statistically significant.

Conclusion

Metabolic tumour volume is a major prognostic factor for DFS and OS in patients with oesophageal squamous cell carcinoma. Higher SUVmax values were paradoxically associated with longer survival. The location of the tumour also appeared to affect prognosis.

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Acknowledgments

This study was partially supported by a grant from the Ligue Contre le Cancer de Haute Normandie and the North West Canceropole (National Cancer Institute - INCa).

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Centre Henri Becquerel and Rouen University Hospital, Rouen, France

    Charles Lemarignier, Sébastien Hapdey, Romain Modzelewski, Pierrick Gouel & Pierre Vera

  2. Department of Gastroenterology, Rouen University Hospital, Rouen, France

    Frédéric Di Fiore, Charline Marre & Pierre Michel

  3. Department of Medical oncology, Centre Henri Becquerel, Rouen, France

    Frédéric Di Fiore

  4. QuantIF (Litis EA 4108 – FR CNRS 3638), University of Rouen, Rouen, France

    Sébastien Hapdey, Romain Modzelewski, Bernard Dubray & Pierre Vera

  5. Department of Radiotherapy and Medical Physics, Centre Henri Becquerel and Rouen University Hospital, Rouen, France

    Bernard Dubray

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  1. Charles Lemarignier
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Correspondence to Pierre Vera.

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Lemarignier, C., Di Fiore, F., Marre, C. et al. Pretreatment metabolic tumour volume is predictive of disease-free survival and overall survival in patients with oesophageal squamous cell carcinoma. Eur J Nucl Med Mol Imaging 41, 2008–2016 (2014). https://doi.org/10.1007/s00259-014-2839-y

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  • DOI: https://doi.org/10.1007/s00259-014-2839-y

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